Can the number of functional teeth potentially affect cognitive function?

Min-Jeong Cho; Ji-Young Kim; Yun-Sook Jung; Hae-Eun Shin; Ha-Young Youn; Tae Jun Park; Youn-Hee Choi; Keun-Bae Song

doi:10.11149/jkaoh.2018.42.2.52

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Cho, Kim, Jung, Shin, Youn, Park, Choi, and Song: Can the number of functional teeth potentially affect cognitive function?

Original Article

J Korean Acad Oral Health 2018;42(2):52-58.

Published online: 15 June 2018

DOI: https://doi.org/10.11149/jkaoh.2018.42.2.52

Can the number of functional teeth potentially affect cognitive function?

Min-Jeong Cho¹, Ji-Young Kim², Yun-Sook Jung¹, Hae-Eun Shin¹, Ha-Young Youn¹, Tae Jun Park¹, Youn-Hee Choi¹, Keun-Bae Song^1,

¹Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, Daegu, Korea

²Department of Dental Hygiene, Ulsan College, Ulsan, Korea

Corresponding Author: Keun-Bae Song Department of Preventive Dentistry, School of Dentistry, Kyungpook National University, 2177 Dalgubeol-daero, Jung-gu, Daegu 41940, Korea Tel: +82-53-660-6875 Fax: +82-53-423-2947 E-mail: kbsong@knu.ac.kr

Received 29 May 2018 Revised 13 June 2018 Accepted 20 June 2018

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

With the growing elderly population, there is an increasing interest in the oral and general health of elderly individuals. Loss of teeth is representative of oral disease in elderly individuals and is associated with medical and dental problems. The purpose of this study was to investigate the relationship between the number of remaining functional teeth and cognitive function.

Methods

A total of 456 (111 public health centers, 261 senior centers, 84 sanatoriums) older adults (aged ≥65 years) residing in Korea were included. A mental health nurse examined the cognitive function using the Korean version of the Mini-Mental State Examination. A dentist examined the number of functional teeth and denture status through an oral examination, while a dental hygienist surveyed the subjective masticatory level using a questionnaire.

Results

The mean age of the participants was 79.5 years (range 65-97 years), and 76.1% of them were women. Participants with a small number of functional teeth had lower cognitive function. In these participants, the odds ratio with poor cognitive function was 2.30 times higher; it was 2.74 times higher after adjusting for age, sex, residence, education, and denture use, and was statistically significant.

Conclusions

Our study suggested that the number of functional teeth was associated with cognitive function in the Korean elderly population.

Keywords: Cognitive function, Elderly, Functional teeth, Subjective mastication

References

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Table 1.

Characteristics of subjects according to the number of functional teeth

Variables	Number of functional teeth
Variables	<20 (N=254)	≥20 (N=202)	P-value*	Mean±SD	P-value^‡
Number of functional teeth	7.49±6.54	25.5±3.08	<0.001	15.47±10.40
Age
65-69	8 (3.1)	15 (7.4)		19.13±10.24^b
70-74	39 (15.4)	36 (17.8)		16.61±10.37^a,b
75-79	64 (25.2)	73 (36.1)	0.001*	17.48±10.09^a,b	0.001^‡
80-84	75 (29.5)	56 (27.7)		14.84±10.39^a,b
≥85	68 (26.8)	22 (10.9)		11.94±10.24^a
Sex
Men	51 (20.1)	58 (28.7)	0.032*	17.12±10.87	0.032^‡
Women	203 (79.9)	144 (71.3)		15.08±10.27
Residence types
Spouse	57 (22.4)	64 (31.7)		17.34±10.53
Others	72 (28.3)	54 (26.7)	0.076	15.37±10.67	0.079
Alone	125 (49.2)	84 (41.6)		14.67±10.18
Education
Elementary school	217 (85.4)	153 (75.7)	0.009*	14.93±10.50	0.009^‡
≥Middle school	37 (14.6)	49 (24.3)		18.31±9.79
Subjective masticatory level
Not good	126 (49.6)	63 (31.2)	<0.001*	13.74±9.72	0.001^‡
Good	128 (50.4)	139 (68.8)		16.87±10.76
Denture usage
No	27 (10.6)	153 (75.7)	<0.001*	24.34±6.59	<0.001^‡
Yes	227 (89.4)	49 (24.3)		9.85±8.31
Cognitive ability
Impaired cognitive	119 (46.9)	56 (27.7)	<0.001*	12.93±10.25	<0.001^‡
Normal cognitive	135 (53.1)	146 (72.3)		17.22±10.24

*P<0.05 by chi-square test.

^‡ P<0.05 by t-test & ANOVA.

^a,b Denoted by Scheffe's post-hoc analysis. SD: Standard Deviation.

Table 2.

Characteristics of the study participants according to the cognitive ability

Variables	MMSE score
Variables	0-23 Impaired cognition	24-30 Normal cognition	P-value*	Mean±SD	P-value^‡
Age
65-69	5 (2.9)	18 (6.4)		25.91±3.10^c
70-74	16 (9.1)	59 (21.0)		25.52±3.41^a,b,c
75-79	47 (26.9)	90 (32.0)	<0.001*	24.31±4.50^a,b,c	<0.001^‡
80-84	58 (33.1)	73 (26.0)		23.05±5.06^a,b
≥85	49 (28.0)	41 (14.6)		22.07±4.62^a
Sex
Men	25 (14.3)	84 (29.9)	<0.001*	25.16±4.23	<0.001^‡
Women	150 (85.7)	197 (70.1)		23.35±4.66
Residence types
Spouse	22 (12.6)	99 (35.2)		25.51±3.25^a
Others	71 (40.6)	55 (19.6)	<0.001*	22.06±5.24^b	<0.001^‡
Alone	82 (46.9)	127 (45.2)		23.83±4.55^c
Education
Elementary school	162 (92.6)	208 (74.0)	<0.001*	23.22±4.56	<0.001^‡
≥Middle school	13 (7.4)	73 (26.0)		26.21±4.15
Denture usage
No	61 (34.9)	119 (42.3)	0.111	24.28±4.44	0.063
Yes	114 (65.1)	162 (57.7)		23.46±4.73
Subjective masticatory level
Not good	83 (47.4)	106 (37.7)	0.041*	23.19±4.79	0.020^‡
Good	92 (52.6)	175 (62.3)		24.21±4.48
Functional teeth
<20	119 (68.0)	135 (48.0)	<0.001*	22.90±4.99	<0.001^‡
≥20	56 (32.0)	146 (52.0)		24.90±3.86

*P<0.05 by chi-square test.

^‡ P<0.05 by t-test & ANOVA.

^a,b Denoted by Scheffe’s post-hoc analysis. MMSE: Mini-Mental Status Examination; SD: Standard Deviation.

Table 3.

Logistic regression analysis for association between masticatory level, number of functional teeth, and cognitive ability

Variables	I		II		III
Variables	OR	95% CI	OR	95% CI	OR	95% CI
Subjective masticatory level
Good	ref.		ref.		ref.
Not good	1.49	1.02-2.18*	1.39	0.93-2.07	1.46	0.96-2.22
Functional teeth
≥20	ref.		ref.		ref.
<20	2.30	1.55-3.41*	1.96	1.29-2.96*	2.74	1.50-4.98*

*P<0.05, CI: Confidence interval; OR: Odds ratio. I: Unadjusted model. II: Age, sex adjusted model. III: Age, sex, residence, education & denture usage adjusted model.

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